Therapy and Change

1. Therapy and Change

2. Psychological Therapies

3. Psychotherapy • An interaction between a trained therapist and someone suffering from psychological difficulties.

4. Eclectic Approach • The most popular form of therapy- it is basically a smorgasbord where the therapist combines techniques from different schools of psychology.

5. Psychoanalysis Psychodynamic therapist try to understand a patients current symptoms by focusing on themes across important relationships, including childhood experiences and the therapist relationship.

6. Psychoanalysis • Freud's therapy. • Freud used free association, hypnosis and dream interpretation to gain insight into the client’s unconscious.

7. Psychoanalytic Techniques • Free Association • Client reports immediately without censoring any feelings or thoughts • Interpretation • Therapist points out, explains, and teaches the meanings of whatever is revealed • Dream Analysis • Therapist uses the “royal road to the unconscious” to bring unconscious material to light

8. Psychoanalytic Methods • Psychotherapists use their techniques to overcomeresistanceby the client. • The psychoanalyst wants you to become aware of the resistance and together interpret (ex. Latent content) it’s underlying meaning.

9. Transference • In psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships. Active Listening: echoing, restating, and seeking clarification of what the person expresses.

10. Focuses of people’s potential for self-fulfillment (self-actualization). Humanistic Basic themes of Humanistic therapy: *The present and future more than the past. *Consciousness rather than unconscious thoughts. *Promoting growth instead of curing illness Those in therapy become “clients” rather than patients.

11. Most widely used Humanistic technique is: Client (Person) Centered Therapy • Developed by Carl Rogers • Therapist should use genuineness, acceptance and empathyto show unconditional positiveregardtowards their clients. Ask me to click on an example.

12. Active Listening • Central to Roger’s client-centered therapy • Empathetic listening where the listener echoes, restates and clarifies. Paraphrase. Instead of saying “I know how you feel” summarize the speakers words in your own words. Invite Clarification: “ What might be an example of that?” Reflect feelings: “it sounds frustrating”

13. Behavioral Therapies • Therapy that applies learning principles to the elimination of unwanted behaviors. • HMMMM…………………The behaviors are the problems- so we must change the behaviors.

14. Classical Conditioning Techniques Counter conditioning: • A behavioral therapy that conditions new responses to stimuli that trigger unwanted behaviors. Two Types: Exposure therapy and aversive conditioning

15. Exposure Therapy:Systematic Desensitization • A type of counter conditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. How would I use systematic desensitization to reduce my fear of old women? The trick: proceed gradually!!

16. Exposure Therapy:Virtual Reality Exposure TherapyLike you are an avatar

17. Aversive Conditioning • A type of counter conditioning that associates an unpleasant state with an unwanted behavior. Drinking whisky at a party, pairing that with throwing up. Just the smell will make you sick. Does it work? Short term yes!

18. Aversive Conditioning What are some ways you can change the behaviors of your friends with aversive conditioning?

19. Operant Conditioning: using positive and negative reinforcers for desired behavior. Token Economy: an operant conditioning procedure that rewards a desired behavior.

20. Cognitive Aaron Beck, changing castastrophizing beliefs about themselves, their situations and their futures. Gentle questioning seeks to reveal irrational thinking,, and then persuade people to remove the dark glasses through which they view life We often think in words: therefore, getting people to change what they say to themselves is an effective way to change their thinking.

21. REBT Therapy • Albert Ellis and his REBT therapy: • Rational Emotive Behavioral Therapy Irrational Ideas

22. Group and Family Therapies Group therapy saves money and great for family conflicts. It also allows people to realize there are other people out there with same problems. Family Therapy: Assumes that no person is an island, that we live and grow in relation to others, especially our families. Grandparent of support groups, Alcoholics Anonymous

23. Does therapy work? The results of many such studies are then digested by a means of meta-analysis, a statistical procedure that combines the conclusions of a large number of different studies. Bottom Line: meta-analysis gives us the bottom-line results of a lot of studies.

24. Alternative Therapies Eye movement Desensitization and Reprocessing (EMDR): Therapy adored by thousands yet others say it is a sham.

25. Alternative Therapies Light Exposure Therapy: Have you ever found yourself oversleeping, gaining weight and feeling lethargic during winter? You might have SAD (Seasonal Affective Disorder)

26. How many therapists does it take to change a light bulb? • Just one, but the light bulb has to want to be changed.

27. Biological Approach or Biomedical Therapy Physically changing the brain’s functioning by altering its chemistry with drugs, or affecting its circuitry with electroconvulsive shock, magnetic impulses, or psychosurgery.

28. Antipsychotic Drugs • Such as chlorpromazine (Thorazine) dampens responsiveness to irrelevant stimuli. It helps positive symptoms of schizophrenia. • The molecules are similar to dopamine to occupy its receptor sites and block its activity. Suggested that overabundance of dopamine contributes to schizophrenia.These medications are strong and can also produce tardive dyskesia (involuntary movements of the facial muscles)

29. Antianxiety Drugs • Like alcohol, antianxiety drugs, such as xanax or ativan depresses the central nervous system. However, does not help the CAUSE of the problem.

30. Antidepressant Drugs • Mood-Stabilizing Medications: The simple salt lithium can be an effective mood stabilizer for those suffering emotional highs and lows of bipolar disorder.

31. Electroconvulsive therapy • Shock treatment for severe depression. Produces seizures. It is like restarting your computer, which solves many a problem even if you don’t know why.

32. Alternative Nuerostimulation Therapies • Magnetic Stimulation: pulses surge through a magnetic coil called Repetitive transcranial magnetic stimulation or TMS • Psychosurgery: Surgery that removes or destroys brain tissue. Lobotomy: used to calm uncontrollably emotional or violent patients. The Dr. would shock the patient into a coma, hammer an ice pick through each eye socket into the brain, and then wiggle it to sever connections running up to the frontal lobes.

33. Ethics • Clients need enough information about the counseling process to be able to make informed choices • Educate clients about their rights and responsibilities • Confidentiality is essential but not absolute • Exceptions: • The client poses a danger to others or self • A client under the age of 16 is the victim of abuse • The client needs to be hospitalized • The information is made an issue in a court action • The clientrequests a release of record

34. 1st Interview • 15%: Chief Complain and free speech • 30%: Pursue specific diagnoses; ask about suicide, history of violence, and substance abuse • 15%: Medical History, review of systems, family history • 25%: Personal and social history, evaluate character pathology • 10%: Mental Status Evaluation • 5%: Discuss diagnosis and treatment with patient; plan next meeting